Tasmanian Times

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

One year later health and hospital system descends into further crisis

One year later health funding actually going backward

The crisis in Tasmania’s health and hospital system continues and will get worse.

This Sunday marks a year since the Hodgman Liberals and Health Minister Michael Ferguson went to the state election with promises that are now proven were not to be believed.

Today Labor held the second meeting of its Wellbeing, Care and Community Development Industry Advisory Council which is working on policies to fix the health crisis and to make life better for Tasmanians in care.

Shadow Health Minister Sarah Lovell said while Michael Ferguson had told Tasmanians he would increase health funding, it has now been revealed it would actually decrease, with a $100m black hole, and Tasmanians are still unable to access adequate health and emergency health care.

Ms Lovell said the Minister’s disastrous handling of the biggest infrastructure project in the state – the Royal Hobart Hospital redevelopment – continues unabated.

“It’s unacceptable that a year after Michael Ferguson promised increased funding to address the health crisis he created, that crisis continues without any end in sight,” Ms Lovell said.

“It’s not good enough that he blatantly broke that promise with the Liberal’s recent Revised Estimates Report showing the government is forecasting to reduce spending on the health system, with $15 million less than the previous year.

“It’s unacceptable that Tasmania’s emergency departments remain at breaking point, patients are queued outside hospitals due to a lack of beds and mental health patients cannot get the treatment when and where it is needed.

“It’s not good enough that Michael Ferguson remains in charge of the $698 million Royal Hobart Hospital redevelopment when he has overseen an on-going series of debacles, the latest of which is his arrogant ignorance of frontline doctors who are telling him the design will not work.

“It’s not acceptable that Tasmanian women are – on Michael Ferguson’s watch – still unable to access legal terminations of pregnancy more than a year after the last Tasmanian clinic closed.

“It’s horrifying that last month’s Productivity Commission Report on Government Services reveals Tasmanians are leaving hospital and then suffering adverse effects at the highest rate in the country.

“Doctors, nurses, allied health professionals and other medical staff are doing an extraordinary job in unnecessarily difficult circumstances created by Michael Ferguson’s continued underfunding of the health system.

“His $100 million funding black hole is responsible for patients continuing to be trapped in emergency departments for days at a time and for staff being pushed to breaking point.

“A year after the election when Tasmanians were conned by false promises around the fundamental human right to an adequate health system, Premier Hodgman must tell them today: Does he still have confidence in Michael Ferguson after his catastrophic performance as Health Minister?”

7 Comments

Morrison’s increased funding for Medicare and pharmaceutical subsidies only flows from our taxes/pockets straight into the pockets of Big Pharma.

Both Liberal and Labor have missed the point. Prevention is infinitely better and cheaper than cure.

Prevent illness by regulating food quality/ingredients properly so that all the added toxins are removed from our ‘foods’. Google all the ingredients in your ‘foods’ to find out why.

And set minimum but high real whole food nutrition standards, especially to fast or convenience ‘foods’.

Did you know that crops like grains and potatoes are sprayed with roundup to force the plants to stress and seed at the same time? Did you know that banana bells are injected with chlorpyrifos, acephate, Imidacloprid and spirotetramate so it is systemic to the whole plant including the bananas you eat?

Ban the use of chemical poisons being sprayed over and injected into our foods. The consumer ends up eating and accumulating these toxins which cause cancers, auto-immune and mental disorders.

None of them are needed if monocultures weren’t the norm.

How much money would be saved if it weren’t wasted on all these poisons in both use and the resulting effects on health?

I look forward to Mr Shorten’s announcement today about this pledge. Hopefully Labor has listened to the calls for help and I hope he actually mentions the crisis situation at the Royal Hobart Hospital.

Sydney Morning Herald, May 5, 2019 – 12.00am – extract:

“Labor pledges $500 million to speed up emergency department wait times

Labor leader Bill Shorten is set to pledge $500 million to speed up emergency department waiting times across Australia as the party seeks to emphasise the benefits of its hardline economic decisions if it wins office in two weeks’ time.
Mr Shorten is expected to reveal the measure during a speech on Sunday to launch Labor’s federal election campaign. He will argue that Coalition government cuts to health spending have led to overcrowded emergency departments and overworked hospital staff.
The Australian Medical Association last month said emergency treatment times for urgent patients went backwards in most states and territories last financial year, and more than a third of the almost 3 million patients who needed urgent treatment waited longer than clinically recommended.
The association has also warned that the federal government’s planned hospital spending over four years is not enough to address a “funding crisis” that is “putting doctors and patients at risk”.
A Labor government would invest $250 million on emergency department upgrades and $250 million on more doctors, nurses and health workers to reduce patient waiting times.
Half the investment would come from Labor’s already announced $2.8 billion Better Hospitals Fund, while the other half represents a new funding commitment.
… The party says it has pledged about $8 billion more than the government on health.
The Morrison government rejects assertions that it has neglected health spending. It cites increasing funding for Medicare and pharmaceutical subsidies, and money for mental health and medical research. It also says Labor has refused to rule out scrapping $6 billion in health insurance rebates if elected.”

I was hoping that the PM and opposition leader whilst both in Tasmania last Thursday would take the golden vote-winning opportunity to be the hero and promise to step in with immediate (crisis management ) actions & increased investment to urgently address the emergency hospital crisis happening right now in Hobart. (cue crickets….)

But instead, there’s just a media release (3 May 2019) by Tasmanian Labor that highlights federal Labor’s commitment to a $95 million public hospital package for Tasmania”. (See below). This is good, I think. Or is it? Will it address the very clear and present danger which has been in operation at the Royal Hobart Hospital with the full knowledge of government for at least a year? ‘Going a long way towards solving the health crisis’ and ‘commitment will help resolve the health crisis’ doesn’t give me confidence in the effectiveness of the package, nor does it indicate to me any emergency management response.

This is a crisis. It needs more than just money promised and eventually thrown at the Tasmanian State Government. The crisis requires immediate intervention; involves far more complex issues and active management than indicated in the federal electioneering; and needs more rigorous federal government oversight to ensure the desired outcomes. I’ll tell you why I’ve come to this conclusion – it’s based on patterns found in the below…

Back in September 2018 the crisis was such that the Australian Government had to get involved and write to the Tasmanian government to find out what’s going on – as follows:

“In Federal Parliament, Denison independent Andrew Wilkie asked Prime Minister Scott Morrison if he would step in and help the Tasmanian Government run the public health system.
Mr Morrison defended the Tasmanian Government, but said he was seeking an update.
“I don’t think it’s okay,” he told parliament.
“The Minister for Health [Greg Hunt] has written to the Tasmanian Government seeking an update on the issues that you’ve raised today.”
The Federal Health Minister … (wrote) a ‘please explain’ over a plan to move Royal Hobart Hospital patients from beds to chairs to help relieve bed block pressures.
Patients awaiting discharge or transfer will be moved to chairs and given a bell “to attract attention in case they need any assistance” under the proposed measures.
Management has refuted claims store rooms at the Royal Hobart Hospital (RHH) will be converted into wards to cope with the high demand that has seen patients sleeping on the floor of the emergency department and ambulances with patients awaiting treatment queued up outside, a process known as ramping.”https://www.abc.net.au/news/2018-09-19/rhh-over-capacity-protocol-plan-for-bed-crisis-defended/10280328

Then in October 2018 the Tasmanian Premier, in a speech to the Liberal Party’s state council meeting, said that the current situation in health “is not good enough”. An understatement if ever there was one; and a simple blame-shifting ‘demand outstripping supply’ explanation was given by Will Hodgman as if this was a surprise development and not attributable to him or his state government up until finding it a top priority now:

“Mr Hodgman told delegates at the annual party conference that health investment was a proven top priority for the Tasmanian Government.
“But the truth is, that demand for services is also escalating, and it’s outstripping supply,” he said.
Mr Hodgman said since 2016, demand in Tasmania’s emergency departments had risen by more than 7,000 patients a year.
He told the room that 12 years ago, the Royal Hobart Hospital Emergency Department treated an average of 108 patients a day, but it now needed to be able to deal with 222 patients a day.
“We do have a very real challenge of meeting today’s demand in yesterday’s hospital,” he said.
He talked up the delivery of the redeveloped hospital, which is set for completion in the middle of next year.
Mr Hodgman said the State Government was continuing to reform a health system that was disconnected and dysfunctional in its second term.
“We know it’s not good enough, it’s a challenge we accept responsibility for and we will respond to the additional demand where we can,” he said.
Mr Hodgman told delegates his government was investing more in health than any previous Tasmanian government, and had recently delivered 22 more beds for the repatriation centre in Hobart.
Figures released last week showed elective surgery waitlists in Tasmania rose by 46 per cent over the past year, with just one third of the Royal’s semi-urgent elective surgery patients seen within clinically recommended timeframes.
Last month a leaked report revealed the health system was underfunded “in excess of $90 million a year”.https://www.abc.net.au/news/2018-10-07/premier-admits-health-system-failing/10348196

Gee, probably in line with population growth, since 2012 hospital emergencies were growing; since 2016 demand was rising rapidly and a crisis was fast developing; and all this was known by state government. Yet despite this, fast forward to late 2018 and the Premier is acting like an innocent bystander watching in slow motion the train wreck and telling his Liberal Party delegates that “it’s a challenge” “we will respond to the additional demand where we can”.

“Respond”, what? “Where we can”, huh? I thought any government’s role – apart from having a vision for the future and steering us there – was to be strategic and therefore manage, monitor, look ahead and plan & prepare for all contingencies. This ‘additional demand’, unmatched public health services and consequent crisis should have been anticipated as a possible risk-management scenario and properly managed in the first place so as to avert.

Seven months on, May 2019, and it would seem that despite the state government’s long and full knowledge of increasing demand and the health system’s dysfunction, and even regardless of receiving a written inquiry from the federal Health Minister prompted by the RHH crisis, the situation not only still persists – Groundhog Day – but has even worsened.

Now we have an avoidable but growing mental health crisis also occurring amongst the poor ambulance drivers who are completely stressed out having to act as ramped-up hospitals-on-wheels for hours on end treating emergency patients. They, along with the hospital medical staff, are witnessing ‘abundant cases of direct patient injury and death’ as a consequence of the RHH crisis. This situation has not been denied by the state Health Minister, Mr Ferguson. Sadly, as further possible evidence of the crisis “The Tasmanian Coroner’s office last week confirmed it was investigating the death of a 71-year-old man in the hospital’s emergency department 12 days ago.” https://www.abc.net.au/news/2019-04-21/rhh-doctors-assessment-gets-ferguson-to-reschedule-meeting/11034424

The federal Liberal government, presumably with in-house knowledge of the RHH crisis, has recently promised substantial investment for Tasmania’s health system. In The Examiner, April 10 2019, I see that the PM announced a $92 million ‘Tasmania Health Plan’ while in Tasmania:

“Elective surgery, mental health care, maternity services and breast cancer diagnosis are among the “priority needs” set to be addressed in a state-specific health funding program, under a Liberal federal government.
Prime Minister Scott Morrison will announce in Launceston on Wednesday almost $92 million in funding to help support a better health care system for Tasmania.
This will include $34.7 million to reduce surgical waiting times, $10.5 million for a walk-in mental health care centre in Launceston, $3 million for two new diagnostic mammography units and $400,000 to support upgrades to new birthing suites at the Launceston General Hospital.
Mr Morrison said the Tasmanian Health Plan would also provide greater support for Tasmanians living in rural and remote locations, while increasing a wide range of vital services, from GPs to hospital care and specialist health services.
“Our strong economic management means we can provide record investment in Medicare, public hospitals and medicines, delivering more doctors, more nurses and more services to Tasmanians,” Mr Morrison said.https://www.examiner.com.au/story/6011370/liberals-announce-health-funds-boost-to-address-tasmanias-priority-needs/

Hmmmm, is it just me or is there a distinct effort not to mention RHH or any hint of crisis there? (I could be cynical and say this is perhaps due to it being a compadre Liberal, not Labor, state government caught out asleep at the wheel). The lack of any public acknowledgement of the Hobart hospital crisis or specific plans for immediate action to avert further injury (and even potentially more deaths) due to it does not give me confidence in the Liberal’s plan to deliver & meet the current health care needs of citizens in Tasmania.

So it’s down to Labor $95 million versus Liberal $91 million+ in their “funding for public hospitals (which) would increase from $425 million a year (2018-19) to $525 million (2024-25), under a new agreement with the Tasmanian Government.”

But what about the emergency patients, their stressed ambulance drivers and all of the impacted hospital staff in crisis right now? Who’s going to step up, take charge and urgently do something?

Tasmanian Labor media release, May 3, 2019:

Only Labor is committed to solving Tasmania’s health crisis

• $95 million public hospital package good news for Tasmania
• Commitment will help resolve the health crisis
• Funding will open up more beds and take pressure off the EDs

Today’s $95 million Federal Labor announcement for public hospitals in Tasmania will go a long way towards solving the health crisis.
Shadow Health Minister, Sarah Lovell, said the commitment will ensure Tasmanians get the care they desperately need.
“The Liberals have plunged our health system to the point of crisis where people are dying unnecessarily in our hospitals and in our community,” Ms Lovell said.
“Ambulance ramping rates have increased 500 per cent in the last three years and the most recent data shows the number of patients waiting for elective surgery has grown by nearly 3,000 to more than 9,000 in just the past 12 months.
“Today’s announcement by the Shorten Labor Government will open up more beds in our hospitals and take the pressure off our emergency departments and prevent ambulance ramping.
“These measures will make a real impact on patient care and will help pull Tasmania’s health and hospital system out of crisis.”

Perhaps someone should pay a visit to Blenheim in NZ and see what they are doing. In a conversation with my mother last night I was told about how my Aunt is about to have a hip operation and her biggest concern is that she might be called to the hospital before she has actually had the consultation with the orthopedic surgeon! From all reports the level of service is excellent, and has been consistent over many years.

This is not typical of the NZ experience, and certainly not the Tasmanian one, as my employer who has been waiting for months for the same operation will attest.

It is impossible to know for sure, but my life experience over 58 years suggests that there is a leadership team in place that is competent, motivated and committed to doing the job it was hired to do. The flip side of that is that it is not unreasonable to presume that the leadership teams in the failing enterprises are less than competent, not motivated to perform at their best, and certainly not committed to providing the best possible outcome for those they are employed to serve.

Blenheim is a regional centre, not unlike Burnie or Latrobe/Devonport, serving a region about the size of Northern Tasmania. If it can attract competent, motivated and committed people there is no reason Tasmania cannot do the same. Clearly there are other forces at work, and these need to be identified and addressed. That is where the opportunity for real improvement will come from, and not from throwing ever larger budgets into the hands of the incompetent, the malfeasant, the lazy and the self interested.

Clearly, if we want to see an improvement in our public administration we need better leadership at the top, and equally clearly, this will not come from party politics whose interests are clearly conflicted, with the common good well down the list.

The solution seems to be more independent minds in the leadership team.

Why don’t the family/families of people who have unnecessarily died because of this ridiculous situation SUE the government and its ministers for their complete lack of responsibility to their Duty of Care?

Couldn’t a Class action be initiated?

Maybe only something like this would get these political scumbags off their arses instead of redirecting all our taxes to their mates!

Here is a system still in crisis and the impacts are growing and ongoing. Now ‘ramping’ is so extreme that the paramedics are suicidal or otherwise suffering psychologically. People in their care are having to wait and at risk of further harm or even death. See news extract below.

Regardless of who is responsible for what between Ambulance Tasmania and the Royal Hobart Hospital, or any reasons for blaming, deflection and delay in resolutions, this risky, dangerous and deadly state of emergency health care is intolerable. Ultimately it would seem that there is no captain at the top (or one willing to actually take charge and be responsible, that is) and this very expensive but rudderless and badly run health vessel is still floundering on the rocks.

Is there anyone at all in government who thinks this issue is of high priority and needs urgent attention? Anyone?

ABC News this morning (1/05/2019):

“Paramedics say ambulance ramping is causing them ‘widespread and undeniable psychological injury’ and warn if nothing is done to address their concerns ‘the consequences could be catastrophic.'”

In a letter to Ambulance Tasmania (AT) CEO Neil Kirby, paramedics in the state’s south describe ambulance ramping and overcrowding at the Royal Hobart Hospital (RHH) as an “unmitigated crisis” that is “entirely unworkable” and affecting the mental health of front-line staff.

“Ambulance Tasmania is in a state of utter disarray with the psychological impact of ramping affecting paramedics in the extremis,” said the paramedic who wrote the letter on behalf of his southern region colleagues.

Earlier this month, executive emergency department registrar doctors wrote a scathing letter to the Tasmanian Health Service executive warning of “direct patient injury and death” because of worsening conditions and bed block.
A paramedic the ABC has named John (in order to protect his employment) said morale among front-line AT staff was at an all-time low, and people were dying after delays accessing hospital care.

John recently spent 11 hours of a 13-hour shift waiting with a patient who needed to be admitted to the RHH’s emergency department.

He said a patient recently transferred from the state’s north with a known abdominal aortic aneurysm requiring surgery was ramped at the RHH for hours, until their vessel burst, requiring life-saving surgery.

The letter from Southern Region paramedics calls on Ambulance Tasmania to stop seeing ambulance ramping as a “hospital problem”, saying not enough was being done by the organisation to manage the impact on staff.

Health And Community Services Union state secretary Tim Jacobson echoed the issues raised by paramedics in the letter to Ambulance Tasmania. “Clearly we have to take these comments very seriously, and immediate action must be taken to ensure our paramedics are not in the circumstances that they are in right now,” he said.

A spokesman from Ambulance Tasmania said the organisation was happy to consider staff input. “Ambulance Tasmania received a letter from a staff member today (Tuesday). As always, we are happy to consider staff input, and we are continuing to work with the Tasmanian Health Service regarding demand pressures on the emergency department,” he said.

About Tasmanian Times

Tasmanian Times is a forum of discussion and dissent - a cheeky, irreverent challenge to the mass media’s obsession with popularity, superficiality and celebrity.

"The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself." - Friedrich Nietzsche